DUTIES: Performs professional nursing duties of a specialized nature in the care of patients requiring the mostrecent advances in general, intravenous, and regional anesthesia for surgical operations, respiratory care,cardiopulmonary resuscitation, pain management and/or fluid therapy, medical procedures, and obstetricservices, within the clinical areas of the main operating room (OR), labor and delivery, pre-operativeclinic, recovery room, and anesthetic procedures out of the OR (including, but not limited to endoscopy,interventional cardiovascular suite, lithotripsy center, pediatric radiology and emergency room). Dutiesinvolve administration of anesthetic agents and supportive treatment of patients undergoing surgery orother medical procedures. Maintains responsibility for determining the optimal type and method ofanesthesia care to administer, for a broad range of surgical procedures, including the most complexperformed at the Medical Treatment Facility (MTF). Scope of practice includes, but is not limited to,direct patient care; patient and staff education; research, consultation and referral, with physician andtherapeutic interventions, as needed. 1. Anesthesiology Technology and Research. Applies a mastery of nursing to the latest developments in the rapid and continuing advancement of theanesthesiology field. Incorporates research, best practices, and leading edge technology in the treatmentof diverse and highly complex patient care, facilitating policy and program changes in the delivery ofprofessional anesthesia services. Applies new pharmacologic advances, with significant emphasis ondrug safety, shorter durations of action, reversibility, and ease of administration. Adapts treatment to newtheories in the focus of patient care, from inpatient to outpatient settings, as well as from available riskmanagement data, and research on the development of new drugs regimens. Maintains abreast of, andparticipates in, evolving and continuing research; incorporates new and approved drugs into the practiceof anesthesia, with emphasis on promoting rapid uptake, low toxicity, intense analgesia, easyreversibility, shorter durations, and fewer side effects. Applies and adapts new theories anddevelopments, designed to facilitate agents of sedation, analgesia and sleep along with improved patientmonitoring systems. Supports, participates in, and promotes ongoing research and publication offindings, for expansion and enhancement of the advanced practice role and latest initiatives inanesthesiology technologies. Initiates and/or participates in the design, implementation, monitoring, andevaluation of clinical research. Disseminates clinical practice and research findings through educationand publication. 2. Direct Patient Care/Anesthesia Delivery. a. Provides anesthesia and related services in accordance with hospital regulatory, licensing andcredentialing policies, and with American Association of Nurse Anesthetists (AANA) Guidelines forNurse Anesthesia Practice and Code of Ethics. Complies with current standards of anesthesia practiceand care. Conducts and participates in educational programs that improve anesthesia nursing practice.Provides anesthesia care that is within the scope of practice as determined by demonstrated competency,licensure and clinical privileges delineated by the MTF. b. Demonstrates competency in pre-anesthesia preparation; anesthesia induction, maintenance, andemergence; conscious sedation; pain management; post anesthesia care; peri-anesthetic and clinicalsupport functions. c. Systematically collects data through interviews, observation, physical examination, and review ofmedical records, prior to scheduled surgery. Evaluates data, with respect to individualized anestheticoptions and current recommended practices within the field, to determine and discuss the optimal type ofanesthesia to be used, and to explain expected outcomes and possible anesthetic complications. Evaluatesinformation and makes professional assessment to prescribe the anesthetic plan, utilizing new andevolving pharmacologic technologies, as appropriate. Consults with anesthesiologist or surgeon, asnecessary, on desired course of action or anesthetic plan. d. Determines necessity for laboratory studies, coordinates ordering of laboratory tests and evaluatesresults. Interprets and reports abnormal diagnostic data and changes in signs and symptoms; modifiesanesthetic plan accordingly. Identifies situations and conditions in which medical consultation, orsurgical consultation, should be performed immediately. Documents assessments, orders, andinterventions, appropriately, in the medical record. e. Administers anesthetic by inhalation, endotracheal intubation, regional, intravenous, or topical. Incorporates new and approved drugs into the practice of anesthesia, with emphasis on promoting rapiduptake, low toxicity, intense analgesia, easy reversibility, shorter durations, and fewer side effects.Induces anesthesia to safe, appropriate levels, and manages patient care throughout the surgicalprocedure. Monitors patient's loss of fluids; determines need for, and administers parenteral fluids,including plasma, blood, and other blood products; sets up solutions and maintains proper flow.Administers vasoactive pharmacologic agents, as needed, to maintain and augment a balanced, safeanesthetic. f. Observes the patient during the surgery, to accomplish and maintain the proper level of anesthesiadepth and to prevent over-dosage. Adjusts the administration of anesthetic agents, as well as other drugs,and utilizes proper methods to support respiratory and circulatory functions of patients. g. Maintains responsibility for all techniques, drugs, and equipment used in the administration ofanesthesia to patients undergoing any, and all forms of, surgical and/or diagnostic procedures. Sets upequipment used in performance of work, and maintains responsibility for the care, sanitation, inspection,and proper functioning. Enforces rules of safety, with respect to highly explosive anesthetics and gases;ensures that patients, personnel, and equipment are properly grounded, and that area is scavenged ofwaste gas anesthetics. h. Provides immediate, post-operative care to patients during their return to the intensive care unit orrecovery room, to ensure clear patient airway, stable vital signs, hemodynamic stability, adequate paincontrol and avoidance of adverse reactions from anesthesia. i. Provides a full range of emergency services, including life-saving procedures, to resuscitate andstabilize patients, within the scope of practice and approved guidelines. Responds decisively to life-threatening changes in patient condition, providing immediate and appropriate emergency measures.Discriminates between normal and abnormal findings, to recognize various disease entities andproblems, requiring consultation or referral to a higher level care facility. j. Participates in the development of peer audit processes, involving a systematic review of anesthesiarecords, to ensure the standard of care is met. Participates in review of the broader types of patient careprocesses, to ensure procedures are in compliance with Joint Commission on Accreditation of Hospitalsguidelines. 3. Administrative Services. a. Utilizes knowledge of QA/QI, infection control, patient and staff safety, and risk management, toensure compliance with established standards. Maintains abreast of health care trends, to support positiveresults in quality care. Participates in departmental continuous improvement programs and processes,emphasizing the latest developments and trends in the anesthesiology field. Formulates and evaluatesclinical care standards and treatment programs for effectiveness in meeting patient needs. Exploresmethods and processes to reduce resource consumption, ensuring the patient receives quality care at themost appropriate level. b. Serves as a resource consultant to a wide variety of professional health colleagues, regarding the latestadvances in nurse anesthesia and nursing practice. Provides consultation to other CRNAs as well asoversight and instruction to, students, residents, interns, and ancillary workers in the field of anesthesia,in both clinical and administrative areas. Provides feedback/evaluations (verbal and written) to thestudent and appropriate school/residency program. Plans and sets up programs for weekly staff meetings;arranges for guest and consultant speakers for educational programs. Delivers in-services andeducational lectures, workshops, and case studies for the purpose of providing knowledge, skill, andintroduce the latest initiatives in the evolving anesthesiology field, to other CRNAs, anesthesiology staff,nurses, and health care professionals/ paraprofessionals. Participates in the Department of Defense(DoD). Outcomes Management Initiative, to improve long-term and continuing health care outcomes ofthe population of patients served. PERFORMS OTHER DUTIES AS ASSIGNED.